Optimal sequencing of urgent surgical cases. Scheduling cases using operating room information systems

Optimal sequencing of urgent cases (i.e., selecting which urgent case should be performed first and which second) may enhance patient safety, increase patient satisfaction with timeliness of surgery, and minimize surgeons' complaints. Before determining the optimal sequence of urgent cases, an operating room (OR) suite must identify the primary scheduling objective to be satisfied when prioritizing pending urgent cases. These scheduling objectives may include: 1) perform the cases in the sequence that minimizes the average length of time each surgeon and patient waits; 2) perform the cases in the order that they were submitted; or 3) perform the cases based on medical priority, as prioritized by an OR director, or surgeons discussing the cases among themselves. We provide mathematical structure which can be used to program a computerized surgical services information system to assist in optimizing the sequence of urgent cases. We use an example to illustrate that the optimal sequence varies depending on the scheduling objective chosen.